NASP Communiqué, Vol. 33, #4

A Reality-Based Approach to Teens and Drugs

By Marsha Rosenbaum

Like many parents, when my children entered adolescence, I wished "the
drug thing" would magically disappear and my children would simply abstain.
But as a drug abuse expert whose research was sponsored by the National Institute
on Drug Abuse, and as a parent, I knew this wish to be a fantasy.

It comes as no surprise to school psychologists and counselors that despite
federal expenditures for prevention “education” exceeding $2 billion per
year (and five to seven times that at state and local levels), government
surveys consistently show that half of American teenagers admit to experimenting
with drugs by the time they graduate from high school, and 8 out of 10 have
tried alcohol.

Today’s adolescents have been exposed, since elementary school, to the most
intensive and expensive anti-drug campaign in history. Haven't they been
told, again and again, to “just say no” by school-based programs such as
Drug Abuse Resistance Education (DARE) and hard-hitting media campaigns?
Why hasn’t the goal of teen abstinence been achieved? Where have we gone
wrong, and what can we, as parents, counselors and
school psychologists, do to ensure the safety of our teenagers?

The Context of Prevention

As a sociologist, I believe it’s important to look at the context of
our prevention efforts. Though we urge our young people to be “drug-free,” the
American public, including children, are perpetually bombarded with messages
that encourage them to imbibe and medicate with a variety of substances.
Alcohol, tobacco, caffeine, over-the-counter and prescription drugs seem
to be everywhere. In fact, the Journal of the American Medical Association recently
reported that 80% of adults in the U.S. use at least one medication
every week, and half take a prescription drug (Kaufman, et al., 2002). Nearly
one in two American adults uses alcohol regularly; and more than one-third
have tried marijuana at some time in their lives, a fact not lost on their
children.

An additional factor makes the “drug-free” mantra problematic. Today's teenagers
have witnessed the increasing “Ritalinization” of
their fellow (difficult-to-manage) students,and stimulants such as Adderal have
become a drug of choice on college campuses. All of us have seen prime-time
commercials for drugs to manage such ailments as “Generalized Anxiety Disorder,” with
teenagers the most recent market for anti-depressants. Teenage drug use seems
to mirror modern American drug-taking tendencies. Therefore, some psychologists
have argued that given the nature of our culture, to define teenage experimentation
with legal and illegal substances as “deviant” is inaccurate.

A common, though faulty, assumption driving our prevention efforts is that
if teenagers simply believe that experimentation with alcohol or other drugs
is dangerous, they will abstain. As a result, many programs include exaggerated
risk and danger messages. Although the old Reefer Madness-style
messages have been replaced with assertions that we now have scientific “proof” that
drugs are dangerous, critical evaluations, particularly of marijuana, pierce
holes in the most common assertions and are inconsistent with students’ observations
and experiences. Hence the cynicism we see in so many teenagers regarding
the anti-drug messages they regularly receive.

Science-Based Education and School Policies

It’s time
to dispense with messages designed to frighten students, and replace them
with drug education based on solid science that will prepare them for lifelong
decisions, such as appropriate dose levels and the effect of combinations,
about a range of substances they might ingest.

On the technical
side, the subject could easily be integrated into a variety of high school
courses and curricula, including physiology and biology (to learn how drugs
affect the body), psychology (to learn how drugs affect the mind), chemistry
(to learn what’s contained in drugs), history and civics (to learn how
drugs have been handled by the government), and social studies (to learn
who uses which drugs, and why).

Even the best education isn’t enough. It is important for students to have
a safe place where they can talk honestly and openly, and share their fears
and concerns without judgment. Many conversations about alcohol and other
drugs already happen in the offices of the trusted school counselor or psychologist,
or as part of a growing number of student assistance programs.

But when dealing with students who are not abstinent, who say "maybe" or "sometimes" or "yes" to
alcohol and other drug use, many professionals face an impossible dilemma.
They want to help, to open honest conversations, but are strapped by abstinence-only,
zero tolerance policies, rendering them unable to advise those students who
need them most. It’s a long road from experimentation to abuse, and school
psychologists, freed up from policies derived from politics rather than science,
can make a real difference in keeping students safe.

Problems with punitive policies. There
are no easy answers when it comes to teenage use of alcohol and other drugs,
but it’s clear that increasingly punitive measures make the situation worse.

Random drug testing, the “silver bullet” promised and promoted by the federal
government, has many pitfalls. First, the largest-ever national survey (76,000
students) to measure drug testing reported in 2003 that there is no difference
in illegal drug use among students from schools with or without drug testing
(Yamaguchi, Johnston, and O’Malley, 2003). Drug testing alienates students,
who must be observed by a school official while urinating to be sure the
sample is their own. The collection of a specimen is a humiliating violation
of the most basic privacy, and especially embarrassing for an adolescent.
Testing can have the unanticipated effect of keeping students from participating
in extracurricular programs—activities that would fill their time during
the peak teenage drug-using hours of 3-6 PM. Finally, drug testing is expensive. School
administrators in Dublin, Ohio, for example, calculated that their $35,000
per year program was not cost-efficient. Of 1,473 students tested at $24
each, 11 tested positive, for a total cost of $3,200 per “positive” student.
They canceled the program and, with the savings, were able to hire a full-time
counselor (Gunja, Cox, Rosenbaum, and Appel, 2003,
see Figures 1 and 2).

In general, “zero tolerance” policies simply push students away, though
research from the National Longitudinal Study of Adolescent Health (McNeely, Nonnemaker, and Blum, 2002) shows that school connectedness
has a direct relationship to lowered health risk behaviors such as drug use. That’s
why last year the California State PTA passed a resolution to “support in-school
suspension, after school interventions, positive behavior mentoring, student
assistance and other programs that offer counseling and education as a preventive
disciplinary response to student drug abuse.” (California State PTA Resolution
C, 2003) Most recently, the National Institutes of Health reported that “get
tough” youth programs, as well as boot camps and DARE, are ineffective. The
report cited various forms of counseling as most effective (National Institutes
of Health, 2004).

Safety First

Similar to comprehensive sex education, reality-based drug education, coupled
with counseling when needed, has the promise of increasing students’ knowledge,
awareness and safety.

Although parents today are strongly encouraged to have “the drug talk” with
their teens, many are uncomfortable with the subject. Some don’t know enough;
others know too much; they’re embarrassed—so the talk falls into the lap
of the school psychologist or counselor. That’s why the Drug Policy Alliance
(www.drugpolicy.org)
created the Safety First project in 1999, as a drug education program for
educators and parents looking for balanced information and alternatives to
failed “just say no”-style approaches, as well as ways to talk with teens
about drugs. We provide free, easily digestible written materials, including
the 17-page booklet, Safety First: A Reality-Based Approach to Teens,
Drugs, and Drug Education, a take-action brochure (Getting Real About
Teens and Drugs), a website (www.safety1st.org) containing balanced
fact sheets about a variety of drugs, a Q & A column, news and more;
and a video (Let’s Talk) of teens talking about drug education. We
are now an allied agency of the California State PTA, and have distributed
over 120,000 packets to parents and educators all over the world. We are
pleased to make these resources available (through our website) to members
of the National Association of School Psychologists.

A popular sample of our materials is a letter I wrote to my own son, published
in the San Francisco Chronicle when he started high school. I received
dozens of e-mails from school counselors, who in turn gave the letter to
concerned parents looking for a way to talk with their own teens. Perhaps
you can use it, too.

Dear Johnny,

This fall you will be entering high school, and like most American teenagers,
you'll have to navigate drugs. As most parents, I would prefer that you
not use drugs. However, I realize that despite my wishes, you might experiment.

I will not use scare tactics to deter you. Instead, having spent the
past 25 years researching drug use, abuse and policy, I will tell you a
little about what I have learned, hoping this will lead you to make wise
choices. My only concern is your health and safety.

When people talk about "drugs," they are generally referring
to illegal substances such as marijuana, cocaine, methamphetamine (speed),
psychedelic drugs (LSD, Ecstasy, "Shrooms")
and heroin. These are not the only drugs that make you high. Alcohol, cigarettes
and many other substances (like glue) cause intoxication of some sort.
The fact that one drug or another is illegal does not mean one is better
or worse for you. All of them temporarily change the way you perceive things
and the way you think.

Some people will tell you that drugs feel good, and that's why they use
them. But drugs are not always fun. Cocaine and methamphetamine speed up
your heart; LSD can make you feel disoriented; alcohol intoxication impairs
driving; cigarette smoking leads to addiction and sometimes lung cancer;
and people sometimes die suddenly from taking heroin. Marijuana does not
often lead to physical dependence or overdose, but it does alter the way
people think, behave and react.

I have tried to give you a short description of the drugs you might encounter.
I choose not to try to scare you by distorting information because I want
you to have confidence in what I tell you. Although I won't lie to you
about their effects, there are many reasons for a person your age to not
use drugs or alcohol. First, being high on marijuana or any other drug
often interferes with normal life. It is difficult to retain information
while high, so using it, especially daily, affects your ability to learn.

Second, if you think you might try marijuana, please wait until you are
older. Adults with drug problems often started using at a very early age.

Finally, your father and I don't want you to get into trouble. Drug and
alcohol use is illegal for you, and the consequences of being caught are
huge. Here in the United States,
the number of arrests for possession of marijuana has more than doubled
in the past six years. Adults are serious about "zero tolerance." If
caught, you could be arrested, expelled from school, barred from playing
sports, lose your driver's license, denied a college loan, and/or rejected
from college.

Despite my advice to abstain, you may one day choose to experiment. I
will say again that this is not a good idea, but if you do, I urge you
to learn as much as you can, and use common sense. There are many excellent
books and references, including the Internet, that give you credible information
about drugs. You can, of course, always talk to me. If I don't know the
answers to your questions, I will try to help you find them.

If you are offered drugs, be cautious. Watch how people behave, but understand
that everyone responds differently even to the same substance. If you do
decide to experiment, be sure you are surrounded by people you can count
upon. Plan your transportation and under no circumstances drive or get
into a car with anyone else who has been using alcohol or other drugs.
Call us or any of our close friends any time, day or night, and we will
pick you up, no questions asked and no consequences.

And please, Johnny, use moderation. It is impossible to know what is
contained in illegal drugs because they are not regulated. The majority
of fatal overdoses occur because young people do not know the strength
of the drugs they consume, or how they combine with other drugs. Please
do not participate in drinking contests, which have killed too many young
people. Whereas marijuana by itself is not fatal, too much can cause you
to become disoriented and sometimes paranoid. And of course, smoking can
hurt your lungs, later in life and now.

Johnny, as your father and I have always told you about a range of activities
(including sex), think about the consequences of your actions before you
act. Drugs are no different. Be skeptical and, most of all, be safe.